Archive for March, 2010

After a year in the making, the Patient Protection and Affordable Healthcare Act has passed. Katie Adams of Investopedia describes “10 Ways the New Healthcare Bill May Affect You.” As long as they aren’t offered employer health coverage you can insure dependent kids up to age 26 now, regardless of whether or not they are in school. The age limit was 19 or 23 if they were in school. Health insurance companies like Mercy Health Plans will not be able to cancel your coverage because you get sick. It was actually common for health insurance companies to cut costs by dropping the coverage of patients who fell ill. Children cannot be denied coverage due to pre-existing conditions beginning this year. In 2014, that will apply to adults as well. Companies will no longer be able to cap the amount of lifetime coverage that patients receive, especially meaningful to people with expensive or chronic conditions.

A big change for people with pre-existing conditions that couldn’t obtain health insurance is that they will be able to purchase coverage through “high-risk pools” run by states that put a cap on your out-of-pocket expenses. By 2014, you have to carry insurance coverage from a company like Aultcare or risk getting fined. There will be government assistance for people who are not covered by employers and can’t afford coverage on their own. There will be more options for coverage in 2014 with insurance marketplaces called “exchanges”. There won’t be as much flexibility with flexible spending accounts in a few years. Fewer expenses will qualify and you won’t be able to put as much pre-tax money into your FSA. Family income greater than $250,000 will be taxed more in Medicare payroll taxes beginning in 2018. Medicare costs will be changing for many, ranging from decreases for people who use it as their primary insurance to increases for high-income people. Look for more details to come regarding the affects of the healthcare bill on you and your insurer.

The passing of the health-care bill on Sunday will bring about changes in the industry for individuals and companies like Fallon Health Insurance. In The Washington Post’s article “When does the health-care bill go into effect,” the newspaper summarizes the timetable. The first change should happen within the year, offering a rebate of $250 for Medicare recipients whose initial prescription drug coverage has run out. Within 90 days, people who were denied insurance based on preexisting conditions will have access to high-risk pools. Changes that will come about for insurance companies within 6 months include a requirement for children to remain on their parents’ policies until age 26 if they desire and the banning of insurance companies imposing lifetime coverage caps, denying coverage when people get sick, and denying children with preexisting conditions coverage.

By 2011, individual and small group insurance plans like UPMC Health Insurance are required to use 80% of premium money towards medical services while large group plans must use 85%. The Medicare payroll tax will be increased and expanded by 2013. Families who earn 400% or less of poverty level income will receive subsidies to buy health insurance by 2014. Also that year, most employers will have to provide insurance coverage or will receive penalties and most Americans will have the same stipulation for obtaining health coverage. High-end insurance policies will have an excise tax of 40% imposed in 2018. And by 2019, health insurance will cover 32 million more people than it does today.

The Washington Post article “Who is left uninsured by the health-care reform bill?” by Ezra Klein contains intriguing information. With two different pie charts showing the number of uninsured Americans both with and without the health-care reform bill, we are better able to compare health insurance coverage both ways. The first chart shows the breakdown of insurance coverage in 2019 without the recently passed health-care reform bill. Uninsured Americans would make up the second largest group of 54 million people. The largest segment would belong to those insured through the employer market by companies like Anthem Blue Cross Blue Shield. Thirty-five million people would have insurance through Medicaid or the Children’s Health Insurance Program (CHIP) while the remaining 30 million Americans would be covered under other non-group plans. Compare the number of Americans uninsured without this health-care reform to the number forcasted with the bill’s passing.

Uninsured Americans should move from the second largest category to the smallest group with the passage of this health-care reform act. Employer market plans will remain the largest group with 156 million people, followed by 44 million on Medicaid or CHIP, 25 million in the other/non-group market with smaller companies like Golden Rule Health Insurance, 24 million in the created exchanges, and 22 million in the smallest category of uninsured. Many skeptics ask why so many Americans would still be uninsured with the passage of the health-care reform bill. The majority of those uninsured would actually be illegal immigrants who are not eligible for insurance coverage through the new program. The other people that make up the uninsured category would be those who choose not to carry coverage in lieu of paying the $750 penalty, those whose income is low enough that they are not required to purchase insurance, and people who qualify for public programs like Medicaid but don’t actually sign up. The bottom line is that only 40 million Americans will be in a different health insurance situation after the health-care reform bill and 75% of those will go from being uninsured to being insured. Most of the others will have moved from individual or small group coverage into the insurance exchanges.

Recent abortion and Medicare disputes in Congress have people wondering what will happen during Sunday’s health care reform vote. According to The New York Times article “Democrats Woo Abortion Foes in Push for Health Bill” by David Herszenhorn and Robert Pear, Democrats seem to be scrambling to get enough votes to pass this historic health care reform. If you compare health insurance reform ideas from past Presidents, President Obama says that all of them were trying to fix this broken system. The Democrats in opposition of abortion support the bill with inclusions banning federal government money from covering the cost of abortions.

There is also a dispute over the rates of Medicare payments between legislators in different states. The original proposal in the bill was taken out to make it more desirable to opposing legislators, but some Democrats want the wording put back. Representatives from states like Oregon disagree with other states getting much higher percentages of Medicare reimbursement. They argued that procedures don’t cost three times as much in Miami as they do somewhere like Portland. Many Americans and Republicans worry that the health care reform on the table will put smaller insurance companies like Aultcare health insurance out of business as they can no longer afford to operate. Political lines have been drawn over the $940 billion health care bill and it remains to be seen whether the bill will pass and if so, what the outcome will be.

Local news source The World wrote about a concerning report from the Robert Wood Johnson Foundation. In “Report: More Oregonians lack health insurance,” the nonprofit health group’s findings are highlighted. There has been a significant increase in the number of Oregon’s middle class citizens that don’t have health insurance. Compare health insurance trends nationally and you get the same type of results. As the national trend has gone the same way as Oregon’s, its citizens are hoping that some type of health care reform will help them obtain health insurance. Ten years ago, Oregon had 98,000 people without health insurance. The 2008 study found 170,000 Oregonians without health coverage.

In the same time frame, the cost of a family’s health insurance increased by 70%. In Oregon, as well as much of the rest of America, the median income for its citizens actually decreased by 1.6%. These statistics make it so hard for people to find good health insurance. Assurant Health is one of the top health insurance companies in the United States, with one million customers all over the map. They work with people who don’t have health insurance through their work or other group coverage. Since many businesses have dropped health insurance benefits or reduced them and 15% of Oregonians working for private businesses are not offered health insurance, Assurant Health would be a good company for Oregonians to look into.

Maternity coverage is often an optional rider with health insurance, so if you are thinking of becoming pregnant or are a woman in her childbearing years, it is important to look for health insurance with maternity coverage. Most employer sponsored plans have maternity coverage included, but you have to be specific with individual plans to choose the right coverage. Having a baby in a hospital averages $6,000-$10,000 and can be even higher depending on whether you have a c-section or the baby has to have extra care. You want your maternity coverage to include visits to your doctor during pregnancy, lab work, hospital stays, sonograms and ultrasounds, prescriptions for pre-natal vitamins and any other medications you need, and care for your newborn.

Some individual health plans have a waiting period before you start receiving maternity coverage. If you have health insurance from a company like Fallon Health Plans, contact them to see what your coverage includes. For women who become pregnant before they have obtained health insurance, it is best to contact state or federal government agencies to see what help they can offer you. Unfortunately there are many risks associated with pregnancy for both the mother and child. Health insurance with maternity coverage is the best way to take the burden of the financial side of things away. Fallon Health Plans of Massachusetts is one of the best insurers in the US. You can look online to determine coverage and available doctors or call and speak with one of their customer service representatives. Most coverage plans will include everything you need for your pregnancy.

In Malcolm Ritter’s Associated Press article “Study suggests too many invasive heart tests given,” the frequency of angiograms is taken into question. It is just one of the recent studies suggesting that Americans are getting too many unnecessary health tests. It is a battle between doctors and insurance companies like Golden Rule Insurance and Mercy Health Plans. Doctors are concerned about missing something and even about getting sued in some cases. For this reason, they are much quicker to order expensive tests for their patients, at a high cost to insurance companies and government programs like Medicare.

An angiogram is performed on patients who may be having a heart attack or who have shown symptoms suggesting serious blockage around the heart. They are also being frequently performed on patients whose symptoms are not as clear cut and those who have high risk traits for heart problems. To perform the test, a small tube is put in either the arm or the groin and threaded through the body to the heart. It checks for blocked arteries that could cause a heart attack by injecting dye through the tube and performing an x-ray. Almost two-thirds of the patients that didn’t have clear cut symptoms don’t have serious blockage found. Researchers believe that doctors need to do a better job determining the patients that really need these expensive tests that have risks associated with them. In order for insurance companies to function well, unnecessary and costly tests should be avoided when possible. The question now is how doctors can best treat their patients while avoiding unnecessary testing.

Aultcare health insurance of Ohio offers a swine flu question and answer document on their website. It highlights the issues that many Americans are concerned with regarding this flu. The best way to avoid spreading the swine flu through sneezing and coughing is to stay away from others as much as possible. Always cover your mouth and nose with a tissue when possible and throw it in the garbage. If you don’t have a tissue, cover your mouth and immediately wash your hands to avoid spreading the swine flu. Wash your hands in hot water for at least 15 seconds or use an alcohol based sanitizer to kill the germs. Many people wonder how serious swine flu actually is. Swine flu is just like other seasonal flus, the severity varies from person to person and could actually result in death for some.

Swine flu is caused by a type A influenza virus that previously only seemed to infect pigs. This particular swine influenza A virus, also known as H1N1, is contagious and spreading from human to human. Typical flu symptoms include fever, cough, sore throat, headache, body aches, fatigue, chills, vomiting and diarrhea. Swine flu spreads through coughing and sneezing on other people. Germs can also be transferred by mouth and even one person touching another and that person touching their own mouth. The best prevention against the flu is getting enough rest, washing hands, drinking a lot of fluids, keeping stress down, and staying away from sick people. Compare health insurance to see what treatments your doctor offers. There are prescription antiviral medications that can make for a milder illness, reduce the illness length, and help avoid serious complications.

In Sunlen Miller’s ABC News article “Obama: No “Straight Answer” from Health Insurance CEOs, Warns of More Premium Hikes to Come Without Up or Down Vote,” Miller talks about this important meeting. President Obama met with health insurance CEOs on Thursday and seemed disappointed with the results of the meeting. When you compare health insurance reform options, the bottom line seems to be that something needs to change. The President doesn’t see insurance companies as willing to make a change. He said that if health care is not reformed soon, premiums will continue to increase, people will continue to have their coverage dropped, and denials due to pre-existing conditions will still happen in high numbers.

The White House meeting with executives from the top five U.S. insurance companies had the goal of helping the health care reform effort. After over a year of debating the issue, President Obama said that Congress owes the American people an up or down vote. While he believes that the process is close to being complete, health care reform has to be voted up in order for the changes Obama sees for the American people to happen this year. He says that lives will be helped tremendously and even saved with his health care reform. Many people disagree with the government takeover of health insurance and wonder where that leaves insurance companies like UPMC. President Obama had hoped for a more positive outcome from his meeting with the CEOs and his reform in general. It remains to be seen what will happen with this longstanding debate over health care.